Predictors of a Persistent Status of Pulmonary Vein Electrical Isolation by a Cryoballoon Application for Drug-Refractory Atrial Fibrillation
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- Kawaguchi Naohiko
- Heart Center, Yokohama-City Minato Red Cross Hospital
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- Okishige Kaoru
- Heart Center, Yokohama-City Minato Red Cross Hospital
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- Yamauchi Yasuteru
- Heart Center, Yokohama-City Minato Red Cross Hospital
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- Kurabayashi Manabu
- Heart Center, Yokohama-City Minato Red Cross Hospital
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- Hirao Kenzo
- Heart Rhythm Center, Tokyo Medical and Dental University
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<p>Background:Pulmonary vein isolation (PVI) using a cryoballoon (CB) is utilized for treating atrial fibrillation. This study aimed to assess the effect of the procedural characteristics of CB-based PVI (CB-PVI) on late PV reconnections.</p><p>Methods and Results:A total of 389 consecutive patients underwent the CB-PVI as their index procedure; 45 consecutive patients underwent re-do procedures (184±87 days after the index CB-PVI). A total of 146 of 178 PVs (82%) remained isolated. The occlusion grade was evaluated in 171 PVs. Complete PV occlusion by the CB (grade 4) was obtained in 122 of 171 PVs (71%) during the index CB-PVI and the PVI status was maintained in 111 PVs (91%). Among the remaining 49 CB-PVIs without complete PV occlusion (grades 1–3), 20 PVs (41%) had late PV reconnections despite successful PVI during the index CB-PVI. A “pull-down maneuver” was performed in 20 PVs because of leakage of blood at the inferior aspect of the PVs, and all those PVs with a successful pull-down maneuver maintained their PVI status. A multivariate analysis demonstrated that the presence of complete PV occlusion was the only independent predictor for persistence of PVI.</p><p>Conclusions:The occlusion grade was a reliable predictor of the long-term durability of PVI.</p>
収録刊行物
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- Circulation Journal
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Circulation Journal 82 (3), 659-665, 2018
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390282680084947328
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- NII論文ID
- 130006394566
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 028849847
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- PubMed
- 29225299
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- 使用不可